Medical device actuator locks

ABSTRACT

A handle of a medical device may comprise an actuator; a lock movable relative to the actuator and having a feature movable relative to the actuator; and a rack having plurality of teeth separated from one another by a plurality of gaps. The lock may be configured to move the feature from (a) a first configuration, in which the feature is disposed in the gap, between two of the plurality of teeth, such that the two teeth inhibit the actuator from rotating; to (b) a second configuration, in which the feature is disposed outside of the gap, such that the actuator is rotatable. In the second configuration, the teeth may be disposed between the feature and the actuator.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority under 35 U.S.C. § 119from U.S. Provisional Application No. 63/132,513, filed on Dec. 31,2020, which is incorporated by reference herein in its entirety.

TECHNICAL FIELD

Various aspects of this disclosure relate generally to devices andmethods for actuators of medical devices, such as elevator levers forduodenoscopes.

BACKGROUND

Duodenoscopes may include a handle and a sheath insertable into a bodylumen of a subject. The sheath may terminate in a distal tip portion,which may include features such as optical elements (e.g., camera,lighting), air/water outlets, and working channel openings. An elevatormay be disposed at a distal tip and may be actuatable in order to changean orientation of a medical device/tool passed through the workingchannel. For example, the elevator may be pivotable or otherwisemovable.

Elements in the handle may control the elements of the distal tip. Forexample, buttons, knobs, levers, etc. may control elements of the distaltip. The elevator may be controlled via a control mechanism in a handle,such as a lever, which may be attached to a control wire that attachesto the elevator. When an actuator (e.g., a lever) is actuated, the wiremay move proximally and/or distally, thereby raising and/or lowering theelevator.

SUMMARY

Each of the aspects disclosed herein may include one or more of thefeatures described in connection with any of the other disclosedaspects.

In one example, a handle of a medical device may comprise an actuator; alock movable relative to the actuator and having a feature movablerelative to the actuator; and a rack having plurality of teeth separatedfrom one another by a plurality of gaps. The lock may be configured tomove the feature from (a) a first configuration, in which the feature isdisposed in the gap, between two of the plurality of teeth, such thatthe two teeth inhibit the actuator from rotating; to (b) a secondconfiguration, in which the feature is disposed outside of the gap, suchthat the actuator is rotatable. In the second configuration, the teethmay be disposed between the feature and the actuator.

Any of the handles disclosed herein may have any of the followingfeatures. The feature may be biased into the first configuration. Aspring may bias the feature into the first configuration. The lock mayinclude at least one of a button or a bar. A shaft may extend radiallyinward, relative to a housing of the handle, from the at least one ofthe button or the bar to the feature. At least a portion of the actuatorand the feature may extend away from the shaft in the same direction.The feature may be substantially parallel to at least a portion of theactuator. The shaft may extend radially through an opening in theactuator. The lock may include the bar. The bar may extend laterallythrough an opening in the actuator. The plurality of teeth may faceradially inward relative to a housing of the handle. The plurality ofthe teeth may face laterally outward relative to a housing of thehandle. The rack may be curved. The rack may be recessed within asurface of the handle. The lock may be movable in a radial directionrelative to a housing of the handle. A shape of the teeth may complementa shape of the feature. Additionally or alternatively, the shaft of thehandle may translate along a track of the actuator.

In another example, a handle of a medical device may comprise: arotatable actuator; a lock radially movable relative to the actuator andconfigured to radially move a feature relative to the actuator; and arack having plurality of teeth separated from one another by a pluralityof gaps. The lock may be configured to move the feature radially inwardtoward a handle housing from (a) a first configuration, in which thefeature is disposed in a gap of the plurality of gaps, between two ofthe plurality of teeth, such that the two teeth inhibit the lever fromrotating, to (b) a second configuration, in which the feature isdisposed radially inward of the teeth, such that the actuator isrotatable.

Any of the handles described herein may have the following features. Thefeature may be biased into the first configuration.

In another example, a method of operating a medical device may comprise:with an actuator in a first position, depressing a lock radially inwardrelative to the actuator, thereby moving a feature radially inward ofteeth of a stationary rack gear; while depressing the lock, rotating theactuator to a second position; and with the actuator in the secondposition, releasing the lock, thereby moving the feature so that theteeth inhibit movement of the feature in a direction of movement of theactuator.

Any of the methods or devices disclosed herein may have any of thefollowing features. The method may further comprise: with the actuatorin the second position, depressing the lock radially inward relative tothe actuator, thereby moving the feature radially inward of the teeth ofthe stationary rack gear; while depressing the lock, rotating theactuator to a third position; and with the actuator in the thirdposition, releasing the lock, thereby moving the feature so that theteeth inhibit movement of the feature in a direction of movement of theactuator. The lock may include a bar or a button.

It may be understood that both the foregoing general description and thefollowing detailed description are exemplary and explanatory only andare not restrictive of the invention, as claimed. As used herein, theterms “comprises,” “comprising,” or any other variation thereof, areintended to cover a non-exclusive inclusion, such that a process,method, article, or apparatus that comprises a list of elements does notinclude only those elements, but may include other elements notexpressly listed or inherent to such process, method, article, orapparatus. The term “diameter” may refer to a width where an element isnot circular. The term “distal” refers to a direction away from anoperator, and the term “proximal” refers to a direction toward anoperator. The term “exemplary” is used in the sense of “example,” ratherthan “ideal.” The term “approximately,” or like terms (e.g.,“substantially”), includes values +/−10% of a stated value.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate aspects this disclosure andtogether with the description, serve to explain the principles of thedisclosure.

FIGS. 1A and 1B depict aspects of an exemplary duodenoscope.

FIGS. 2A and 2B depict a first lever for use with the duodenoscope ofFIGS. 1A-1B.

FIGS. 3A and 3B depict a second lever for use with the duodenoscope ofFIGS. 1A-1B.

FIGS. 4A, 4B, 4C, and 4D depict a third lever for use with theduodenoscope of FIGS. 1A-1B.

DETAILED DESCRIPTION

It may be desirable to lock actuators or controllers of medical devices(for example, levers) of duodenoscopes in a desired position. Forexample, it may be desirable to retain a lever that controls an elevatorin a desired position. Such locks may free an operator to make use of afinger that would otherwise be used to retain the lever in position.Furthermore, the lever may require a high amount of force from anoperator to retain the lever in place without a locking/retainingmechanism. Locking/retaining mechanisms may help to avoid fatigue by theuser. The examples disclosed herein use fixed gear structures tolock/retain an actuator (e.g., a lever) in a desired position. Althoughelevator levers are described herein, it will be appreciated that thedisclosed levers may also be used for other types of controls (e.g.,steering of a distal tip of the duodenoscope).

FIG. 1A depicts an exemplary duodenoscope 10 having a handle 12 and aninsertion portion 14. FIG. 1B shows a proximal end of handle 12.Duodenoscope 10 may also include an umbilicus 16 for purposes ofconnecting duodenoscope 10 to sources of, for example, air, water,suction, power, etc., as well as to image processing and/or viewingequipment. Although the term duodenoscope may be used herein, it will beappreciated that other devices, including, but not limited to,endoscopes, colonoscopes, ureteroscopes, bronchoscopes, laparoscopes,sheaths, catheters, or any other suitable delivery device or medicaldevice that may include an elevator or another actuatable distal tipcomponent, may be used in connection with the devices and manufacturingmethods of this disclosure. Although side-facing devices areparticularly discussed, the embodiments described herein may also beused with front-facing endoscopes (e.g., endoscopes where a viewingelement faces longitudinally forward) or any other device where a usermay desire the ability to lock or unlock a portion of the device.

Insertion portion 14 may include a sheath or shaft 18 and a distal tip20. Distal tip 20 may include an imaging device 22 (e.g., a camera) anda lighting source 24 (e.g., an LED or an optical fiber). Distal tip 20may be side-facing. That is, imaging device 22 and lighting source 24may face radially outward, perpendicularly, approximatelyperpendicularly, or otherwise transverse to a longitudinal axis of shaft18 and distal tip 20.

Distal tip 20 may also include an elevator 26 for changing anorientation of a tool inserted in a working channel of duodenoscope 10.Elevator 26 may alternatively be referred to as a swing stand, pivotstand, raising base, or any suitable other term. Elevator 26 may bepivotable via, e.g., an actuation wire or another control element thatextends from handle 12, through shaft 14, to elevator 26.

A distal portion of shaft 18 that is connected to distal tip 20 may havea steerable section 28. Steerable section 28 may be, for example, anarticulation joint. Shaft 18 and steerable section 28 may include avariety of structures which are known or may become known in the art.

Handle 12 may have one or more actuators/control mechanisms 30. Controlmechanisms 30 may provide control over steerable section 28 or may allowfor provision of air, water, suction, etc. For example, handle 12 mayinclude control knobs 32, 34 for left, right, up, and/or down control ofsteerable section 28. For example, one of knobs 32, 34 may provideleft/right control of steerable section 28, and the other of knobs 32,34 may provide up/down control of steerable section 28. Handle 12 mayfurther include one or more locking mechanisms 36 (e.g., knobs orlevers) for preventing steering of steerable section 28 in at least oneof an up, down, left, or right direction. Handle 12 may include anelevator control lever 38 (see FIG. 1B). Elevator control lever 38 mayraise and/or lower elevator 26, via connection between lever 38 and anactuating wire that extends from lever 38, through shaft 18, to elevator26. A port 40 may allow passage of a tool through port 40, into aworking channel of the duodenoscope 10, through sheath 18, to distal tip20.

In use, an operator may insert at least a portion of shaft 18 into abody lumen of a subject. Distal tip 20 may be navigated to a proceduresite in the body lumen. The operator may insert a tool (not shown) intoport 40, and pass the tool through shaft 18 via a working channel todistal tip 20. The tool may exit the working channel at distal tip 20.The user may use elevator control lever 38 to raise elevator 26 andangle the tool toward a desired location (e.g., a papilla of thepancreatico-biliary tract). The user may use the tool to perform amedical procedure.

FIGS. 2A and 2B disclose views of a handle 112, which may have any ofthe properties of handle 12 of FIGS. 1A-1B. Handle 112 may have alocking/retaining mechanism 160. Handle 112 may have an elevator controllever 138, having any of the properties of elevator control lever 38 ofFIG. 1B. Locking mechanism 160 includes a stationary rack gear 180 andfeatures of elevator control lever 138 that interact with rack gear 180in order to retain/lock elevator control lever 138 in a desiredposition.

Elevator control lever 138 may include a lever body 162 and a cross bar164. Cross bar 164 may be an actuator for locking/retaining and/orreleasing elevator control lever 138, in a desired position. A radiallyouter surface 165 of cross bar 164 may extend radially outwardly fromlever body 162. Radially outer surface 165 of cross bar 164 may extendradially outwardly from lever body 162 by only a small amount in orderto facilitate a user contacting lever body 162 and cross bar 164 withoutany uncomfortable protrusions. Cross-bar 164 may extend laterally (e.g.,substantially perpendicularly to a longitudinal axis of handle 112)through at least a portion of elevator control lever 138. Elevatorcontrol lever 138 may have an opening (e.g., a slit) extending at leastpartially therethrough for receiving cross bar 164.

As shown in FIG. 2B, cross bar 164 may include an arm/shaft 168 thatextends radially inward from radially outer surface 165. A feature, suchas a tooth 166, may be disposed at a radially inward end of arm 168.Tooth 166 and lever body 162 may extend in substantially the samedirection away from arm 168. A radially outward portion of cross bar 164(having surface 165), arm 168, and tooth 166 may form a substantiallyC-shape. Tooth 166 may extend laterally inward (in a direction toward acenter of handle 112). Tooth 166 may have a first end 172 and a secondend 174. First end 172 may be flat, and second end 174 may be curved.Alternative shapes may be used for first end 172 and second end 174within the scope of the disclosure. A radially outer surface 165 ofcross bar 164 (and other portions of cross bar 164) may extend furtherin the lateral direction than tooth 166 does, in order to facilitatetooth 166 engaging with stationary rack 180, as discussed in furtherdetail below. Cross-bar 164 (including arm 168 and tooth 166) may besubstantially flat (i.e., side surfaces of cross-bar 164 may be planar).

Elevator control lever 138 and cross bar 164 may include any suitablematerial. For example, elevator control lever 138 and/or cross bar 164may include polymers (e.g., plastic), composites, or metal. In oneexample, elevator control lever 138 may be formed from plastic, andcross bar 164 may be formed from metal. Elevator control lever 138 maybe formed of a single, unitary material or a plurality of componentssecured to one another. Cross-bar 164 may be formed of a single, unitarymaterial or a plurality of components secured to one another.

Stationary rack gear 180 may include a plurality of teeth 182, separatedfrom one another by gaps 184. Rack gear 180 may have a curved shape, tomatch an arcuate path traveled by elevator control lever 138 when lever138 is actuated. Teeth 182 may extend in a laterally outward direction(away from a center of handle 112). As shown in FIG. 2B, each tooth 182may have a ledge 186 that extends further in a lateral direction than aremainder of tooth 184. A body 188 of tooth 182 may be recessed fromledge 186 and may have a rounded/arcuate radially inner surface. A shapeof teeth 182 and gaps 184 may complement a shape of tooth 166. Forexample, rounded/arcuate radially inner surface of body 188 maycomplement a rounded shape of tooth 166.

Stationary rack gear 180 may be formed integrally with a housing ofhandle 112. Alternatively, stationary rack gear 180 may be a separatepiece that is fixedly attached to a housing of handle 112. Stationaryrack gear 180 may be one single piece or may be formed from a pluralityof pieces. Stationary rack gear 180 may be formed from any suitablematerial or combination of materials (including, e.g., polymer, such asplastic, composite, or metal).

In operation, a user may make contact with lever body 162 of elevatorcontrol lever 138 in order to raise or lower the elevator. In doing so,the user may depress cross bar 164 in a radially inward direction, byexerting a radially inward force on radially outward surface 165 ofcross bar 164. Cross-bar 164 may be rigid such that tooth 166 movesradially inward. As cross bar 164 is depressed, a radially outwardsurface of tooth 166 of cross bar 164 may move radially inward of ledge186, such that tooth 166 does not interfere with teeth 182 of gear rack180. Thus, when cross bar 164 is depressed, the user may move elevatorcontrol lever 138 to raise or lower the elevator.

Cross-bar 164 may be biased in a radially outward direction to theconfiguration of FIG. 2B. For example, cross bar 164 may have shapememory properties, or a spring may exert a radially outward force oncross bar 164. Alternatively, cross bar 164 may attach to lever 138 viaa living hinge or other biased hinge, so that a normal (i.e., relaxed)position of cross bar 164 is as shown in FIG. 2B. Cross-bar 164therefore moves relative to lever 138. Therefore, when the user releasescontact from surface 165 of cross bar 164, cross bar 164 may moveradially outward to the configuration of FIG. 2B. In the configurationof FIG. 2B, tooth 166 may be positioned within gap 184 such that tooth166 interferes with teeth 182 of stationary gear rack 180 (e.g., tooth166 may be between two adjacent 186) along a direction of movement oflever 138. In the configuration of FIG. 2B, a position of tooth 166 ofcross bar 164 may prevent elevator control lever 138 from being moved toraise or lower the elevator. Interaction between cross bar 164 andstationary rack gear 180 may thus retain elevator control lever 138 in adesired position (e.g., locking elevator control lever 138).

Because stationary rack gear 180 may have a plurality of teeth 182 andgaps 184, locking mechanism 160 may serve to retain elevator controllever 138 within a plurality of positions, and therefore retain elevator26 in any of a number of positions. A user may choose a position atwhich to lock elevator control 138. The user may also depress cross bar164 to move elevator control lever 138 and then release cross bar 164 toretain/lock elevator control lever 138 in a new position.

FIGS. 3A and 3B depict an alternative handle 212, which may have any ofthe properties of handles 12 or 112, except as specified below. Some ofthe structures of FIG. 3A are transparent on FIG. 3B, in order to showdetails of particular aspects. Where feasible, parallel referencenumbers are used to denote like structures between handles 212 and 112.Handle 212 may include a locking mechanism 260. Locking mechanism 260may include an elevator control lever 238 that interacts with astationary rack gear 280.

Elevator control lever 238 may have a lever body 250 (shown in FIG. 3Abut omitted from FIG. 3B for clarity). Lever body 250 may have an angledshape that conforms to a surface of handle 212. As shown in FIG. 3A,lever body 250 may have two segments 252, 256 that extend along asubstantially radial direction. Between segments 252 and 256 is asegment 254 that extends substantially laterally, perpendicular tosegments 252 and 256. A radially outer end of segment 256 may be joinedto a segment 258 that extends substantially parallel to segment 254.Segment 254 may form an end of lever body 250. Lever body 250 may be onesingle piece or may be formed from a plurality of pieces. Lever body 250may be formed from any suitable material or combination of materials(including, e.g., polymer, such as plastic, composite, or metal).

A button 264 may extend approximately parallel to segment 258 and may bedisposed radially outward of segment 258. Button 264 may be an actuatorfor locking/retaining lever 238 in a desired position and/orreleasing/unlocking lever 238. A spring 276 may extend between segment258 of lever body 250 and button 264. Button 264 may be movable in asubstantially radial direction, approximately parallel to segments 252and 256. Spring 276 may bias button 264 in a substantially radiallyoutward direction (which, as discussed below, may be a lockedconfiguration). Other, alternative means may also be used to bias button264 radially outward, into a configuration in which button 264 is notdepressed. For example, button 264 may have shape memory properties.

A shaft 268 may be fixed to and extend radially inward from button 264(e.g., from an end of button 264). Shaft 268 may extend substantiallyparallel to segments 252 and 256. Segment 256 may be disposed betweenshaft 268 and a housing of handle 212. Shaft 268 may extend radiallyinward through an opening in segment 254 and may be movable relative tolever body 250, along with button 238. Button 238 and shaft 268 may beone single piece or may be formed from a plurality of pieces. Button 238and shaft 268 may be formed from any suitable material or combination ofmaterials (including, e.g., polymer, such as plastic, composite, ormetal).

Housing 278 may enclose one or more of segment 256, segment 258, spring276, and/or portions of shaft 268 that are radially outward of segment254. Button 264 and shaft 268 may be movable relative to housing 278.

As shown in FIG. 3B, a feature, such as a peg 266, may extend laterallyinward from shaft 268, substantially parallel to segments 254 and 258.Peg 266 may extend in a direction toward an interior of handle 212(toward segment 256). Peg 266, segment 254, and button 264 may extendaway from shaft 268 in substantially the same direction. Peg 266, shaft268, and button 264 may form approximately a C-shape. Peg 266 may have,for example, a rounded shape or any other suitable shape. Peg 266 andshaft 268 may be one single piece or may be formed from a plurality ofpieces. Peg 266 and shaft 268 may be formed from any suitable materialor combination of materials (including, e.g., polymer, such as plastic,composite, or metal).

Stationary rack gear 280 may be formed on a surface of a housing ofhandle 212 that faces radially inward. For example, stationary rack gear280 may be a cut-out formed in a housing of handle 212. A plurality ofteeth 282 and a plurality of gaps 284 between teeth 282 may be formed onthe radially-inward facing surface of the housing of handle 212. Teeth282 may face/extend radially inward. Because stationary rack gear 280 isformed on a cutout, teeth 282 may not interfere with a finger/hand of auser (which may cause an operator's glove to rip, for example).Stationary rack gear 280 may have a curved shape to correspond to a pathof motion of lever 238.

Gaps 284 may have a curved (e.g., substantially semicircular)cross-sectional shape. Alternatively, gaps 284 may have another shape. Ashape of gaps 284 may complement a shape of peg 266.

Stationary rack 280 may be integrally formed with a housing of handle212 or may be a separate piece from the housing of handle 212.Stationary rack 280 may be one single piece or may be formed from aplurality of pieces. Stationary rack 280 may be formed from any suitablematerial or combination of materials (including, e.g., polymer, such asplastic, composite, or metal).

In operation, a user may depress button 264, which may move shaft 268 ina substantially radially inward direction, thereby moving peg 266 in asubstantially radially inward direction. Peg 266, when moved in asubstantially radially inward direction, may clear teeth 282 ofstationary gear rack 280, such that teeth 282 do not interfere with peg266. In other words, an entirety of peg 266 may be disposed radiallyinward of teeth 282. Thus, when button 264 is depressed, elevatorcontrol lever 238 (including lever body 250) may be moved to adjust apositioning of the elevator.

When the user releases button 264, spring 276 may exert a force onbutton 264 in a substantially radially outward direction (i.e., button264 may be biased to the undepressed configuration). As button 264 movesradially outward, shaft 268 and peg 266 also move radially outward. Whenbutton 264 is not depressed, peg 266 may be disposed within a gap 284 ofstationary rack gear 280. At least a portion of peg 266 may be disposedradially inward of a radially outward edge of surrounding teeth 282.Teeth 282 may interfere with peg 266 along a direction of movement oflever 238. Teeth 282 may thus limit movement of peg 266 and, thus,elevator control lever 238.

Because stationary rack gear 280 may have a plurality of teeth 282 andgaps 284, locking mechanism 260 may serve to retain elevator controllever 238 at a plurality of positions, and thereby secure elevator 26 atany of a plurality of positions. A user may choose a position at whichto lock elevator control 238. The user may also depress button 264 tomove elevator control lever 238 and then release button 264 toretain/lock elevator control lever 238 in a new position.

FIGS. 4A-4D depict an alternative handle 312, which may have any of theproperties of handles 12, 112, or 212 except as specified below. Wherefeasible, parallel reference numbers are used to denote like structuresbetween handles 312, 212, and 112. Similar to handle 212 depicted inFIGS. 3A and 3B, handle 312 may include a locking mechanism 360. Lockingmechanism 360 may include an elevator control lever 338 that interactswith a stationary rack gear 380, shown in FIGS. 4B and 4C and to bedescribed further herein.

Elevator control lever 338 may include a button 364 positioned radiallyoutward from adjacent portions of handle 312, toward a user. Button 364may be an actuator for locking/retaining elevator control lever 338 in adesired position and/or releasing/unlocking lever 338. An outermostsurface of button 364 may include a smooth surface, a rough surface(i.e. textured), or otherwise be padded to provide comfort to the userand/or to facilitate a more secure grip. The elevator control lever 338,including its button 364, like any other structure of locking mechanism360, may be comprised of a variety of materials, such as composites,stainless steel, plastics, polymers, or any alternative or combinationof materials commonly used in the art. For example, button 364 may becomprised of a composite material, and a remainder of control lever 338may be comprised of a stainless steel or plastic.

Button 364 is surrounded by, and translates within, a housing 339.Housing 339 is ring-like and defines an internal aperture 339′ thatreceives and houses button 364. FIG. 4D shows housing 339 and aperture339′, without button 364. iButton 364, when pressed, will translaterelative to housing 339 towards surfaces of handle 312.

Housing 339 is integral with, or otherwise connected to, and fixed to anarm 378 (shown in more detail in FIGS. 4C and 4D). Arm 378 has asemi-circular cross-sectional shape (see FIG. 4A) and provides supportto control lever 338 and raises control lever 338 away from outersurfaces of handle 312, to limit undesired interactions during usebetween the control lever 338 and the handle 312 or other components ofdevice 10 of FIG. 1. Arm 378 is integral with, or otherwise connectedto, and fixed to a lever body 350. Alternatively, arm 378 may be aseparate component coupled to lever body 350 by means of glue,fasteners, a press-fit, or any other means commonly known in the art.Lever body 350 may have a shape that conforms to, complements, orotherwise wraps around, a surface of handle 312.

Lever body 350 is integral with, or otherwise connected to, and fixed toa ring 351 that movably couples control lever 338 to the remainder ofhandle 312. Ring 351 encloses and defines an inner aperture 351′ thatreceives structure for connecting knobs 32, 34 to parts internal to thehandle housing, for causing articulation of the distal end of the scope.Ring 351 mounts to the handle housing in a manner that permits rotationof ring 351 about its central axis, as locking lever 338 isrotated/pivoted by a user.

FIG. 4B shows an outer surface of handle 312. Stationary rack 380 may beintegrated into or otherwise formed with handle 312. Stationary rack 380may comprise a plurality of teeth 382 separated by a plurality of gaps384. Stationary rack 380 may be curved along the handle 312 so as toengage with the elevator control lever 338 along the entire length ofthe path of motion of lever 338. Stationary rack 380 may have a radiusof curvature that is the same as or approximately the same as the radiusof curvature of the path of motion of lever 338. The plurality of teeth382 and the plurality of gaps 384 may be one size or a variety of sizesso as to engage with lever 338. Each of the plurality of teeth 382 mayextend perpendicularly away from the outer surface of handle 312.Stationary rack 380 may be an integral component of handle 312 or aseparate component fixedly coupled to handle 312 by means of glue, apress-fit, ultrasonic welding, fasteners, or any other means commonlyknown in the art. In such a configuration, stationary rack 380 may becomprised of the same material as handle 312 or a different material.For example, handle 312 may be comprised of a polycarbonate material,and stationary rack 380 may be comprised of a stainless steel.

FIG. 4C shows a cross-section of locking mechanism 360 to demonstratethe interaction between internal components of control lever 338 andstationary rack 380. A protrusion 371 of button 364 travels within arecess 370 of housing 339 and prevents the button 364 from travellingtoo far, acting as a stop to limit radially inward movement of button364. For example, in a pressed configuration of button 364, protrusion371 travels downward within recess 370 of housing 339. Button 364 isstopped (i.e. can no longer be pressed) when a bottom face of protrusion371 abuts a bottom face within the recess 370. Similarly, button 364 isprevented from continuous upward travel once a top face of protrusion371 abuts a top face of recess 370, or, as described below, a distalshaft 368 abuts segment 358, as described below. The length and depth ofrecess 370 may vary according to the desired amount of travel for button364. On the opposite side of button 364, a protrusion 373 of button 364travels within an opening 379 of arm 378 and lever body 350. A top faceof protrusion 373 may abut a bottom face of 372 of opening 379 in afirst configuration, as shown in FIG. 4C. Opening 379 of arm 378 andlever body 350 contains a shaft 367. Opening 379 may function to providespace for the working assembly and to provide linear space for distalshaft 368, protrusion 373, and shaft 367 to move. Opening 379 may bedefined by alternative features, such as lever body 350 or alternativeconfigurations of arm 378. Shaft 367 may be fixed to and extend radiallyinward from button 364 (e.g. from an end or bottom surface of button364). Shaft 367 may extend substantially parallel relative to arm 378and/or extend perpendicularly to the bottom surface of button 364. Shaft367 may further comprise a flange/extension 369. Extension 369 mayextend radially outwardly or perpendicularly from a center axis of shaft367. Extension 369 may be utilized to hold or confine a spring 376 to alower portion (as shown) or upper portion of shaft 367. However,extension 369 may be omitted in other embodiments such that the spring376 is not confined to a limited portion of the shaft 367. Shaft 367 mayextend radially inward through an opening in a wall/segment 358 and maybe movable relative to lever body 350 and arm 378, along with button364. Segment 358 may extend perpendicularly outward from a surfacedefining opening 379, and divides opening 379 into a portion abovesegment 358 (housing spring 376) and a portion below segment 358. Button364 and shaft 367 may be one single piece or may be formed from aplurality of pieces. Shaft 367 may be circular in cross-section (asshown), square, rectangular, or otherwise shaped to fit within opening379 and the opening in segment 358.

A distal end of shaft 367 may include a distal shaft 368. Distal shaft368 may be a separate component of shaft 367 or be otherwise formed witha remainder of shaft 367 (i.e. as one component). Distal shafts 368 isconfined below segment 358 to, along with other portions of shaft 367and spring 369, control the displacement of button 364. Segment 358 mayextend the entire width of opening 379 to create two openings (379 and379′), as shown in FIG. 4D. Alternatively, segment 358 may extend apartial width of opening 379 such that opening 379 is continuous aboveand below segment 358. Distal shaft 368 may be rectangular incross-section, as shown, or otherwise shaped to fit within opening 379′.Distal shaft 368 may include grooves in its sides that travel along atrack 390 (shown in FIG. 4D) extending within opening 379, 379′. Track390 can be utilized to ensure distal shaft 368 remains in position toprevent jamming or breakage of the locking mechanism 360.

As shown in FIG. 4C, a feature, such as a peg 366, may extend laterallyoutward from distal shaft 368 and toward an interior of handle 312. Peg366, distal shaft 368, shaft 367, and button 364 may form approximatelya C-shape. Peg 366 may have, for example, a rounded shape or any othersuitable shape to fit between teeth 382 and within gaps 384 of the rackgear 380. Gaps 384 and teeth 382 may be shaped similarly to the gaps andteeth of previous embodiments, described above with reference to FIGS.2A-3B.

The embodiment of FIGS. 4A-4D operates in a similar manner to theembodiment described in FIGS. 2A-3B. For example, in a firstconfiguration, when button 364 is released, button 364 is biased upwardby spring 376. In this released state, a top surface of shaft 368 maytouch or abut a bottom surface of segment 358 and prevent additionallateral, or upward, movement of the button 364. Additionally oralternatively, protrusion 371 may touch or abut a bottom surface ofopening 370 in the released state. This may occur simultaneously as thetop surface of shaft 368 touches or abuts the bottom surface of segment358 or this may occur as a fail-safe, for example, if protrusion 358fails during use. Additionally, in this configuration, peg 366 ispositioned within a gap 384 and between teeth 382. Accordingly, in thisposition, the control lever 338 is locked, unmovable, and cannot pivotor rotate.

To unlock the lever 338, a user may depress button 364. When button 364is depressed, the spring 376 is depressed and shaft 367 and distal shaft368 are lowered within openings 379, 379′. In effect, peg 366 is movedin a substantially radially inward direction, clearing the bottom ofteeth 382. With peg 366 below teeth 382, elevator control lever 338 ismovable (i.e. in an unlocked position) and can be pivoted/rotated. Inalternating between the first configuration and the secondconfiguration, a user can achieve a desired position of the elevator oraccessory tool (not shown).

While principles of this disclosure are described herein with referenceto illustrative examples for particular applications, it should beunderstood that the disclosure is not limited thereto. Those havingordinary skill in the art and access to the teachings provided hereinwill recognize additional modifications, applications, and substitutionof equivalents all fall within the scope of the examples describedherein. Additionally, a variety of elements from each of the presentedembodiments can be combined to achieve a same or similar result as oneor more of the disclosed embodiments. For example, elements of FIGS.2A-2B may be combined with one or more elements of the embodimentsdepicted in FIGS. 3A-3B and/or 4A-4D. Accordingly, the invention is notto be considered as limited by the foregoing description.

We claim:
 1. A handle of a medical device, the handle comprising: anactuator; a lock movable relative to the actuator and having a featuremovable relative to the actuator; and a rack having plurality of teethseparated from one another by a plurality of gaps, wherein the lock isconfigured to move the feature from (a) a first configuration, in whichthe feature is disposed in the gap, between two of the plurality ofteeth, such that the two teeth inhibit the actuator from rotating; to(b) a second configuration, in which the feature is disposed outside ofthe gap, such that the actuator is rotatable, and wherein, in the secondconfiguration, the teeth are disposed between the feature and theactuator.
 2. The handle of claim 1, wherein the feature is biased intothe first configuration.
 3. The handle of claim 2, further comprising aspring, wherein the spring biases the feature into the firstconfiguration.
 4. The handle of claim 1, wherein the lock includes atleast one of a button or a bar.
 5. The handle of claim 4, wherein ashaft extends radially inward, relative to a housing of the handle, fromthe at least one of the button or the bar to the feature.
 6. The handleof claim 5, wherein at least a portion of the actuator and the featureextend away from the shaft in the same direction.
 7. The handle of claim5, wherein the feature is substantially parallel to at least a portionof the actuator.
 8. The handle of claim 4, wherein the shaft extendsradially through an opening in the actuator.
 9. The handle of claim 4,wherein the lock includes the bar, and wherein the bar extends laterallythrough an opening in the actuator.
 10. The handle of claim 1, whereinthe plurality of teeth extend radially inward relative to a housing ofthe handle.
 11. The handle of claim 1, wherein the plurality of theteeth extend laterally outward relative to a housing of the handle. 12.The handle of claim 1, wherein the rack is curved.
 13. The handle ofclaim 1, wherein the rack protrudes from a surface of the handle. 14.The handle of claim 1, wherein the lock is movable in a radial directionrelative to a housing of the handle.
 15. The handle of claim 1, whereinthe shaft translates along a track of the actuator.
 16. A handle of amedical device, the handle comprising: a rotatable actuator; and a lockradially movable relative to the actuator and configured to radiallymove a feature relative to the actuator; and a rack having plurality ofteeth, wherein the lock is configured to move the feature radiallyinward toward a handle housing from (a) a first configuration, in whichthe teeth inhibit the lever from rotating, to (b) a secondconfiguration, in which the feature is disposed radially inward of theteeth, such that the actuator is rotatable.
 17. The handle of claim 16,wherein the feature is biased into the first configuration.
 18. A methodof operating a medical device, the method comprising: with an actuatorin a first position, depressing a lock radially inward relative to theactuator, thereby moving a feature radially inward of teeth of astationary rack gear; while depressing the lock, rotating the actuatorto a second position; and with the actuator in the second position,releasing the lock, thereby moving the feature so that the teeth inhibitmovement of the feature in a direction of movement of the actuator. 19.The method of claim 18, further comprising: with the actuator in thesecond position, depressing the lock radially inward relative to theactuator, thereby moving the feature radially inward of the teeth of thestationary rack gear; while depressing the lock, rotating the actuatorto a third position; and with the actuator in the third position,releasing the lock, thereby moving the feature so that the teeth inhibitmovement of the feature in a direction of movement of the actuator. 20.The method of claim 18, wherein the lock includes a bar or a button.